Canadian Dental Care Plan (CDCP): Paper Claims, Preauthorizations, Post-determinations and Reconsiderations

Description

This PIA assesses the privacy implications of the activities related to handling of personal information for paper claims, preauthorization requests, post-determinations and reconsideration requests under the CDCP. Health Canada is responsible for delivering the CDCP and has contracted Sun Life to administer the program. Oral Health Providers can now submit claims in paper format to Sun Life for services provided to CDCP members. They may also submit preauthorization requests for certain dental procedures that require Sun Life's approval in advance to be covered under the CDCP. In emergency situations, they can submit these requests after the service has been provided. If Sun Life denies a request, the Oral Health Provider may submit a reconsideration request, which is also handled by Sun Life.

Why a Privacy Impact Assessment was completed

Section C.2.2.9 of the Treasury Board of Canada Secretariat (TBS) Directive on Privacy Practices requires Health Canada to complete a Privacy Impact Assessment (PIA) prior to undertaking a new program or activity that could involve the creation, use, disclosure, retention or disposal of personal information.

Additional information

The PIA confirmed that no new privacy risks have emerged for the CDCP. However, 3 mitigations identified in the CDCP Phase 3 PIA are still in progress and will further strengthen privacy protection for the Paper Claims, Preauthorization's Post-determinations and Reconsiderations activity. This includes updating privacy notices to meet TBS requirements, confirming that digitization and practices meet Government of Canada standards as well as finalizing retention and disposition plans.

Related Personal Information Banks

The relevant PIB for this activity is the CDCP PIB – HC PPU 440.

For more information about this Privacy Impact Assessment

If you would like more information about this Privacy Impact Assessment (PIA) please contact DentalEnquiries-DemandesDentaires@hc-sc.gc.ca.